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[Nonoperative management of spontaneous splenic rupture in infectious mononucleosis]

Andrzej B Szczepanik1, Sławomir Gajda, Anna M Szczepanik

  • 1Instytut Hematologii i Transfuzjologii w Warszawie, Klinika Chirurgii Ogólnej i Hematologicznej. chirurg@ihit.waw.pl

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|May 21, 2011
PubMed
Abstract

Insights

Spontaneous splenic rupture, a rare infectious mononucleosis complication, can be safely managed nonoperatively in stable patients. This case highlights successful conservative treatment, avoiding splenectomy.

Area of Science:

  • Internal Medicine
  • Gastroenterology
  • Emergency Medicine

Background:

  • Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis (IM).
  • Nonoperative management is the standard for hemodynamically stable patients with splenic rupture.
  • Infectious mononucleosis affects 0.1-0.5% of patients, with splenic rupture being a rare sequela.

Observation:

  • A 19-year-old male presented with spontaneous splenic rupture during confirmed infectious mononucleosis without trauma.
  • Imaging revealed splenic hematomas and hemoperitoneum; however, the patient remained hemodynamically stable.
  • Conservative management included vital sign monitoring, serial imaging, and activity limitation.

Findings:

  • Serial imaging demonstrated complete resolution of splenic hematomas and hemoperitoneum by day 20.
  • The patient's vital signs and blood cell counts remained stable throughout hospitalization.
  • The patient was discharged in good general condition, indicating successful nonoperative treatment.

Implications:

  • Nonoperative management is a viable and safe alternative to splenectomy for hemodynamically stable patients with spontaneous splenic rupture.
  • This case supports conservative treatment strategies for splenic rupture associated with infectious mononucleosis.
  • Early recognition and appropriate monitoring can lead to favorable outcomes in spontaneous splenic rupture.

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